Expert review of clinical pharmacology
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Expert Rev Clin Pharmacol · Jan 2015
EditorialPrediction of treatment outcomes in major depressive disorder.
Improving the treatment of major depressive disorder will require identification of moderators that predict differential outcomes across treatments at the level of the individual patient, referred to as precision medicine. Currently, there are no biological measures demonstrated to enhance treatment selection accuracy although there are some clinical variables that have prognostic value. ⋯ Genetic combination tests, systemic inflammation, electroencephalography and neuroimaging, in particular, show significant potential for near-term development as clinically meaningful moderators for use in treatment selection. Ultimately, combinations of moderators may provide the greatest level of precision in selecting optimal treatment approaches for individual depressed patients.
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Expert Rev Clin Pharmacol · Jan 2015
EditorialClinical trial design for rare cancers: why a less conventional route may be required.
Major recent advances in the diagnosis, treatment, prevention and screening of cancer have led to improvements in survival and other outcomes for cancer patients. When the 198 identified rare cancers are taken in aggregate, rare cancers account for 22% of all cancer diagnoses, higher than any single common cancer. ⋯ Overcoming the challenges inherent in the study of rare diseases is critical to achieve improvements in outcomes for patients. Combining a redesign of clinical trial protocols with the new paradigm for the treatment of all cancers, may lead to improvements in survival benefits for rare cancers in line with those achieved in the treatment of more common types.
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Expert Rev Clin Pharmacol · Sep 2014
Editorial ReviewTreating chronic pain: the need for non-opioid options.
Chronic pain is a prevalent problem that exacts a significant toll on society. The medical system has responded to this issue by implementing pain management services centered on opioid pharmacotherapy. However, for many chronic pain patients, the analgesic efficacy of long-term opioids is limited. ⋯ As such, non-opioid treatment options are needed. This article first provides a selective review of cognitive, affective, and psychophysiological mechanisms implicated in chronic pain to be targeted by novel non-opioid treatments. Next, it briefly details one such treatment approach, Mindfulness-Oriented Recovery Enhancement, and describes evidence suggesting that this intervention can disrupt the risk chain linking chronic pain to prescription opioid misuse.
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Expert Rev Clin Pharmacol · Jul 2014
EditorialSildenafil for pulmonary hypertension complicating bronchopulmonary dysplasia.
Sildenafil, a phospohodiesterase-5 inhibitor, is widely used to treat pulmonary hypertension in infants with bronchopulmonary dysplasia despite a lack of evidence to support either safety or efficacy and US FDA advice against its use.
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Expert Rev Clin Pharmacol · May 2014
EditorialWhat are our pharmacotherapeutic options for MERS-CoV?
Since the initial description of Middle East Respiratory Syndrome-coronavirus (MERS-CoV), the disease has been associated with a high case-fatality rate. There is a lack of proven effective medications for therapy of MERS-CoV. The current knowledge of therapeutic options for MERS-CoV is based on the experience from SARS-CoV and from in vitro studies. In this article we review the different therapeutics available for MERS-CoV from SARS experience, in vitro and animal studies of this emerging disease.